Despite the increasing burden of rheumatic diseases on the US population, there is a national shortage of rheumatology investigators in major medical centers working to find the causes and cures of these debilitating disorders. The Rheumatology Training Program at the University of Washington (UW) is designed to help address this important shortfall and has a long-standing track record of success. The UW attracts highly qualified trainees both from within the residency program and nationally that are motivated to help fill this urgent need. The goal of our combined adult and pediatric training program is to provide MD and PhD postdoctoral fellows high quality basic or clinical science training in rheumatic disease and to equip them to become independent academic researchers. Several major changes to our training program were instituted during the last funding period we have: 1) created 3 pathways -basic, clinical and translational to accommodate the needs, interests and skills of both the applicant pool and mentors in the program; 2) linked the program to access to a number of robust biorepositories to facilitate translational research; 3) consolidated our pool of outstanding established mentors and recruited a significant number of new mentors and co-mentors to facilitate training in new pathways; 4) recruited new faculty to both adult and pediatric rheumatology divisions; 5) promoted our mentors-in-training to mentors in the program; and 5) increased the number of ACGME fellowship positions. The proposed training for this competitive renewal requests 5 postdoctoral fellowship positions. In addition, based on the need to attract medical students to the exciting field of rheumatology and previous success in recruiting medical students into our fellowship training program, we are requesting two annual short-term summer electives for medical students. The fellowship program is open to MDs who have completed a clinical year in Rheumatology and PhDs who have completed their accredited training. MDs in the clinical pathway are required to enter the Masters or Certificate Program in epidemiology or public health at the UW School of Public Health. Our typical trainee completes three years of basic and clinical science training during which time all trainees are expected to publish their work and submit a fellowship(s) grant. A formal mentoring program that assists trainees with career and scientific guidance, and a well- designed core curriculum, provides all trainees with essential skills in grant writing and other assets required for long-term success. Finally, two committees (Selection & Advisory and External Advisory) assist the joint Program Directors in programmatic governance, and to ensure the programmatic benchmarks and expectations are achieved.